Employmentweb_low

EmploymEnt, Work, And hEAlth InEquAlItIEs - a global perspective
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This chapter explores the pathways linking social determinants with
individual health. Pathways are a shortcut for hypothetical causal
chains whose mechanisms have, for the most part, yet to be
uncovered. Gaps in knowledge are identified for these pathways,
which are divided into three levels: the macrosocial level (for
example, the employment rate), the middle-range or institutional
level (labour contracts and other forms of employment relations),
and the microsocial level (working conditions such as the
psychosocial work environment). This section ends with case
studies that illustrate the complexity of uncovering pathways and
mechanisms in this area.
8.1. Macro-socioloGical eMPloyMenT relaTions and
The healTh of naTions
our model (figure 14) begins with power relations as macrosocial
determinants of employment conditions (i.e., the type of
employment arrangement or “axes” in our terminology),
employment inequalities according to gender, ethnicity, race,
migrant status (“dimensions” in our terminology), as well as other
social determinants such as social and health policies. in turn,
employment relations determine proximal working conditions,
which are shaped by the employers’ need to maximise labour
effort and profits. The explicit link between employment and
working conditions (the reduction of labour costs and the
maximisation of labour effort) are what sets our model apart from
conventional social epidemiology (Marmot, 2004) and
occupational health (Karasek & Theorell, 1990). our model also
includes social networks as a moderating force on the effects of
employment and working conditions on individual health.
however, we do not touch on these non-employment related
factors in the following analyses.
Power relations (mostly in governments and labour markets)
can be characterised by indicators such as gender inequality in
the labour market or the proportion of precarious or informal
workers. Thus, country-level macro-sociological indicators of
inequalities in employment relations offer an initial macrosocial
level of analysis of population health. causal pathways
originating at the national level cannot be uncovered with intracountry,
individual-level data since macrosocial factors are held
constant within countries (see rose, 1992). labour market
indicators at the national level have been incorporated in just a
small number of recent population health studies (Muntaner et
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